Table of Content

  

10 February 2020
Volume 58 Issue 2

6-Gingerol reduces atrial fibrosis induced by angiotensin Ⅱ in rats

ZHAO Weikun, LYU Xiangwei, WU Qi, LU Pan, PENG Li, QIN Qiuyu

Journal of Shandong University (Health Sciences). 2020, 58(2):  1-6.  doi:10.6040/j.issn.1671-7554.0.2019.1047

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Objective To investigate the effect and mechanism of 6-Gingerol(6-G)on atrial fibrosis induced by angiotensin Ⅱ(Ang II)in rats. Methods Eighteen 8-week-old male SD rats were randomly divided into sham operation group, model group, and 6-G intervention + Ang II group, with 6 rats in each group. Rats in sham operation group received 2 mg/kg 0.9% sodium chloride injection in the tail vein. Rats in model group received 2 mg/kg AngⅡ injection 山 东 大 学 学 报 (医 学 版)58卷2期 -赵位昆,等.6-姜酚减轻血管紧张素Ⅱ诱导的大鼠心房纤维化 \=-to induce atrial fibrosis. Rats in 6-G intervention + AngⅡ group received 6 mg/kg 6-G injection, and then 2 mg/kg Ang II injection after 30 min. Drugs were continuously administered for 14 days, once a day. The cardiac function was observed with echocardiography, changes of myocardial injury markers were determined with ELISA, degree of atrial fibrosis was measured with Massons trichrome staining, and TGF-β1 and collagen-Ⅰ expressions were detected with Western blotting. Results There were no statistically significant differences in LVEF(F=1.500, P=0.255), LVFS(F=0.793, P=0.471), LVESD(F=0.104, P=0.902), LVEDd(P=0.566)CK-MB(F=0.089, P=0.915), and cTnT(F=0.181, P=0.836)among the three groups(P>0.05). Compared with sham operation group, the model group and 6-G intervention + Ang II group had severer atrial fibrosis, elevated collagen fraction(F=322.527), TGF-β1(F=44.537)and Collagen-Ⅰ (F=45.626), and the differences were statistically significant(P<0.05). Compared with sham operation group, the model group had comparable cardiac function and myocardial injury markers(P>0.017), but severer atrial fibrosis, elevated collagen fraction, TGF-β1 and Collagen-I, and the differences were statistically significant(P<0.017). Compared with the model group, the 6-G intervention + AngⅡ group had no statistically different cardiac function and myocardial injury markers(P>0.017), but reduced atrial fibrosis, decreased collagen fraction, TGF-β1 and Collagen-Ⅰ, and the differences were statistically significant(P<0.017). Conclusion 6-G can improve AngⅡ-induced atrial fibrosis by inhibiting TGF-β1 and Collagen-Ⅰ expressions.

Effects of interferon-stimulated gene GPR135 on the replication of vesicular stomatitis virus

LYU Yahui, DOU Chunhui, LI Fan, LI Daqi

Journal of Shandong University (Health Sciences). 2020, 58(2):  7-12.  doi:10.6040/j.issn.1671-7554.0.2019.1046

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Objective To investigate the expression changes of G protein-coupled receptor(GPCR)135 in pathogen infection and its effects on the replication of vesicular stomatitis virus(VSV). Methods The expressions of GPR135 in mouse peritoneal macrophages(PEMs)in the cases of pathogen infection and interferon stimulation were detected with real-time fluorescent quantitative polymerase chain reaction(Q-PCR). The eukaryotic expression vector was constructed to overexpress GPR135 in HEK-293T cells. The effects of GPR135 overexpression on VSV replication were examined. Results In pathogen infection, GPR135 expression was increased(P<0.05). Interferon stimulation also led to an increase of GPR135 expression(P<0.05). After Stat1 interference, viral infection and interferon stimulation failed to upregulate Gpr135 expression. After GPR135 overexpression in HEK-293T cells, RNA replication of VSV was reduced(P<0.05), and expression of VSV glycoprotein(VSV-G)was significantly decreased. Conclusion In pathogen infection, interferon up-regulates GPR135 through the JAK-STAT signaling pathway and Gpr135 can be regarded as an interferon-stimulated gene. Overexpression of GPR135 in HEK-293T cells inhibits VSV replication.

Menstrual blood mesenchymal stem cells improve premature ovarian failure in mice via IGF-1 signaling

XU Yanyan, YAN Bei, WANG Rui, WANG Hongyan

Journal of Shandong University (Health Sciences). 2020, 58(2):  13-20.  doi:10.6040/j.issn.1671-7554.0.2019.1278

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Objective To investigate the effect and molecular mechanism of menstrual blood mesenchymal stem cells(MenSCs)transplantation on the ovarian function in mice with premature ovarian failure(POF)induced by chemotherapy. Methods A total of 48 C57BJ female mice were randomly divided into control, POF and MenSCs groups. The POF models were induced by intraperitoneal injection of cyclophosphamide combined with busulfan, and the MenSCs models were established by injecting MenSCs via tail vein 3 days after chemotherapy. The mRNA expression of growth factor receptor-binding protein 10(GRB10)in ovaries was detected with qRT-PCR. The protein expressions of GRB10, forkhead box O3(FOXO3a), p-FOXO3a, insulin-like growth factor receptor(IGF-1R), p-IGF-1R, protein kinase B(AKT)and p-AKT were detected with Western blotting. Results The concentration of serum estradiol in the control group, POF group, and MenSCs group was(222.29±35.13),(90.87±28.76), and(193.24±48.74)pg/mL, respectively(F=19.332, P<0.001), and it was lower in POF group than in control group(P<0.001)and MenSCs group(P<0.001). The number of superovulated mature eggs was 40.00±10.07, 9.00±7.42, and 24.60±10.24, respectively(F=13.792, P=0.001), and it was higher in control group(P<0.001)and MenSCs group(P=0.021)than in POF group, and higher in control group than in MenSCs group(P=0.039). The gray value of GRB10 protein bands was 1.22±0.05, 1.82±0.13, and 1.10±0.09, respectively (F=94.340, P<0.001), and it was higher in POF group than in control group(P<0.001)and MenSCs group(P<0.001). The gray value of p-FOXO3a protein bands was 0.80±0.08, 0.33±0.06, and 0.76±0.05, respectively(F=98.673, P<0.001), and it was lower in POF group than in control group(P<0.001)and MenSCs group(P<0.001). The gray value of p-IGF-1R protein bands was 0.31±0.10, 0.32±0.08, and 0.42±0.01, respectively(F=3.882, P=0.044), and it was higher in MenSCs group than in control group(P=0.023)and POF group(P=0.039). The gray value of p-AKT protein bands was 0.57±0.02, 0.51±0.05, and 0.64±0.03, respectively(F=22.227, P<0.001), and it was higher in MenSCs group than in control group(P=0.005)and POF group(P<0.001), and higher in control group than in POF group(P=0.004). Conclusion Via the binding of IGF-1 and IGF-1R, MenSCs transplantation may upregulate p-IGF-1R expression while downregulate GRB10 expression, activate IGF-1 signaling pathway, upregulate p-FOXO3a expression, and thereby activates the development of primordial follicles and improves POF.

YAP gene overexpression promotes tongue squamous carcinoma growth through PI3K/AKT/mTOR signaling pathway

WANG Ying, ZHANG Yafei, WEN Yong

Journal of Shandong University (Health Sciences). 2020, 58(2):  21-28.  doi:10.6040/j.issn.1671-7554.0.2019.1034

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Objective To explore the molecular mechanism of YAP gene overexpression on the proliferation and apoptosis of tongue squamous carcinoma cells through the PI3K/AKT/mTOR signaling pathway. Methods CAL27 and SCC25 cell lines overexpressing YAP gene were constructed. The effects of YAP gene overexpression on cell proliferation, cell cycle and apoptosis were detected with CCK-8 and flow cytometry. Effects of YAP gene overexpression on the CDK4, CDK6, p21, BAX and PI3K/AKT/mTOR signaling pathways were analyzed with Western blotting. Results The mRNA expression of YAP in the overexpressing group was higher than that in the control group(t=-19.29, P<0.001; t=-5.44, P<0.001), and the protein expression was also higher(t=-31.28, P<0.001; t=-42.84, P<0.001). In the overexpressing group, the proportion of cells in G1 phase decreased, while the proportion of cells in S phase 山 东 大 学 学 报 (医 学 版)58卷2期 -王莹,等.过表达YAP基因通过PI3K/AKT/mTOR信号通路促进舌鳞癌增殖 \=-increased; the numbers of both early apoptosis and late apoptosis cells reduced; the protein expressions of CDK4, CDK6, BCL-2, PARP increased, while the protein expressions of p21, BAX and caspase3 decreased. YAP gene overexpression increased the expressions of AKT(t_CAL27=-30.60, P<0.001; t_SCC25=-16.77, P<0.001), p-AKT(t_CAL27=-10.23, P<0.001; t_SCC25=-10.67, P<0.001), mTOR(t_CAL27=-13.93, P<0.001; t_SCC25=-9.57, P<0.001), and p-mTOR(t_CAL27=-17.17, P<0.001; t_SCC25=-8.51, P<0.001). Conclusion YAP gene overexpression promotes proliferation of CAL27 and SCC25 cells and inhibits apoptosis through the PI3K/AKT/mTOR signaling pathway.

Early expression of Frizzled 4 in peri-implant tissues of hyperlipidemic rats

LI Yuan, WANG Qiang, SHI Xiaolei, ZHANG Xiaoli, XU Xin

Journal of Shandong University (Health Sciences). 2020, 58(2):  29-35.  doi:10.6040/j.issn.1671-7554.0.2019.830

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Objective To investigate the early expression of Frizzled 4 in peri-implant tissues of hyperlipidemic rats. Methods A total of 48 adult male SD rats were randomly divided into two groups, with 24 rats in either group. Rats in the experimental group were fed with high fat diet, while rats in the control group were fed with common diet for 8 weeks. Implants 1.5 mm wide and 2.5 mm long were implanted into the metaphyseal end of femur. The rats were sacrificed on the 1st, 3rd, 5th and 28th days after operation to obtain bone tissues around the implant. The tissues were scanned with Inveon MM CT and 1 mm area around the implant was set as the area of interest(ROI). Three-dimensional reconstruction was performed in ROI. Bone trabecular parameters were analyzed, including trabecular volume/ROI volume(BV/TV), trabecular thickness(Tb.Th), trabecular number(Tb.N)and trabecular space(Tb.S). The gene expressions of osteoblasts, osteoclast differentiation markers Runt-related transcription factor 2(RUNX2), cathepsin K(CTSK)and Frizzled 4 were detected with RT-PCR. The protein expression of Frizzled 4 was determined with Western 山 东 大 学 学 报 (医 学 版)58卷2期 -李源,等.卷曲受体蛋白4在高脂血症大鼠种植体周围组织中的早期表达 \=- blotting. Results There were no significant differences in BV/TV, Tb.S, Tb.Th and Tb.N between the two groups on the 1st and 3rd day of implantation(P>0.05). On the 5th and 28th days of implantation, the experimental group had lower BV/TV, Tb.Th and Tb.N but higher Tb.S than the control group(P<0.05). On the 1st, 3rd, 5th and 28th days of implantation, the experimental group had lower mRNA expression of Runx2 but higher mRNA expression of CTSK than the control group(P<0.05). In the control group, the mRNA and protein expressions of Frizzled 4 increased significantly on the 3rd day of implantation, and decreased on the 5th and 28th days, but were still higher than those in the experimental group(P<0.05). In the experimental group, both mRNA and protein expressions of Frizzled 4 decreased significantly on the 3rd day of implantation, but increased on the 5th and 28th days(P<0.05). In the control group, the protein expression of Wnt/β-catenin increased significantly on the 3rd day of implantation, and decreased on the 5th and 28th days, but was still higher than that in the experimental group(P<0.05). In the experimental group, the expression of Wnt/β-catenin increased significantly on the 3rd day of implantation, but decreased on the 5th and 28th days(P<0.05). Conclusion Hyperlipidemia can inhibit early osseointegration of implants, which may be related to the down-regulation of Frizzled 4 expression. The exact mechanism needs further research.

Effects of dietary structure and selenium concentration on glucose metabolism in rats

SUN Fengjiao, LI Yan, WANG Yuxin, ZHANG Tianran, WU Hong, GAO Xibao

Journal of Shandong University (Health Sciences). 2020, 58(2):  36-43.  doi:10.6040/j.issn.1671-7554.0.2019.1393

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Objective To explore the effects of different selenium concentrations and dietary structures on glucose metabolism. Methods A total of 150 6-week-old Wistar rats were randomly divided into 15 groups, with 5 female and 5 male rats in each group. Each group was fed for 4 weeks with 3 different concentrations of selenium and 5 different dietary structures, altogether 15 kinds of feedings. The weight of rats was measured every week. After 4 weeks, the rats were sacrificed, the serum selenium and glucose levels were detected, and the effects of different selenium concentrations and dietary structures on glucose metabolism were analyzed. Results There were differences in effects between male and female rats: female rats had smaller growth rate of body weight than male rats(P<0.001); female rats had lower selenium level than male rats, and the difference was statistically significant except in the ordinary control group(P<0.05). Different selenium concentrations and dietary structures had effects on serum selenium level, and there was an interaction effect in female rats(P=0.003). Female rats had lower serum glucose level than male rats, and the differences were statistically significant in high-protein group, high-glucose group and high-fat group(P<0.05). There was an interaction between the effects of different selenium concentrations and dietary structures on blood glucose(P<0.05). Conclusion There is an interaction between selenium concentration and dietary structure on serum selenium and glucose levels in rats, but the specific mechanism remains to be further explored.

Safety and efficacy of neuronavigation-guided minimally invasive aspiration for 17 patients of supratentorial intracerebral hemorrhage with hernia

ZHANG Chunyun, HE Wei, JIANG Bin, WEI Zhaosheng, WANG Zhigang

Journal of Shandong University (Health Sciences). 2020, 58(2):  44-48.  doi:10.6040/j.issn.1671-7554.0.2019.1334

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Objective To evaluate the safety and efficacy of neuronavigation-guided aspiration for large supratentorial intracerebral hemorrhage complicated with hernia. Methods A total of 33 patients with supratentorial intracerebral hemorrhage treated during Jul. 2017 and Dec. 2018 were divided into 2 groups: neuronavigation-guided minimally surgery group(n=17)and craniotomy group(n=16). The operation time, evacuation rate and postoperative complications were compared. The preoperative and postoperative 1d neurological status were evaluated with Glasgow Coma Scale(GCS). The neurological recovery was evaluated with modified Rankin Scale(mRS). Results There were no significant difference in baseline parameters between the 2 groups. The neuronavigation-guided group had significantly shorter operation time but higher evacuation rate than the craniotomy group(P<0.01). There was no difference in postoperative 1d GCS(P=0.29). The mRS score was significantly improved in neuronavigation-guided group 6 months after surgery(P=0.026). There was no significant differences in the incidence of complications such as rehemorrhage and hydrocephalus. Conclusion Neuronavigation-guided minimally invasive aspiration is simple, safe and effective in the treatment of supratentorial intracerebral hemorrhage with hernia. It can facilitate recovery of neurological function and improve patients prognosis.

Application of polyethylene glycol electrolyte powder in intestinal preparation of 40 cases before gynecological laparoscopic operation

ZHANG Zhaoyi, HAN Ting, SUN Yanping, LI Bo

Journal of Shandong University (Health Sciences). 2020, 58(2):  49-53.  doi:10.6040/j.issn.1671-7554.0.2019.1381

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Objective To investigate the application of polyethylene glycol electrolyte powder(PGEP)in intestinal preparation before gynecological laparoscopic surgery. Methods A total of 80 patients undergoing laparoscopic gynecological surgery during Feb. 2019 and May 2019 were randomly divided into two groups. The study group used soap water enema combined with oral PGEP solution for intestinal preparation before operation, while the control group used soap water enema for intestinal preparation. The blood indexes and intestinal preparation effects of the two groups were compared. Results There were no significant differences between the two groups in blood potassium, blood sodium, hemoglobin, hematocrit, pH value, incidence of hyponatremia/hypokalemia, exhaust time after operation and satisfaction of surgeons with intestinal preparation(P>0.05). No severe hyponatremia, hypokalemia or serious complications occurred. Blood glucose was 4.90(4.70, 5.28)mmol/L in the study group and 5.25(4.83, 5.70)mmol/L in the con- 山 东 大 学 学 报 (医 学 版)58卷2期 -张召义,等.聚乙二醇电解质散在40例妇科腹腔镜术前肠道准备中的应用 \=-trol group(z=-2.30, P=0.02), and operation time was 35.00(25.00, 50.00)min in the study group and 57.50(41.25, 90.00)min in the control group(z=-4.01, P<0.001). Conclusion PGEP does not affect blood potassium, blood sodium, hemoglobin, hematocrit and blood pH before gynecological laparoscopic operation. It can improve the intestinal preparation results of soapy water without affecting the recovery of intestinal peristalsis.

Clinics, pathology and prognosis of 30 children with nephrotic syndrome in clinical trials of lupus nephritis

KAN Nana, YU Lichun, SUN Shuzhen, LI Qian, LUAN Chunli

Journal of Shandong University (Health Sciences). 2020, 58(2):  54-59.  doi:10.6040/j.issn.1671-7554.0.2019.1268

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Objective To summarize the clinical and pathological characteristics of children with nephrotic syndrome(NS)in clinical trials of lupus nephritis(LN), analyze the treatment plan and prognosis, and provide reference for the diagnosis and treatment. Methods Clinical data of children diagnosed with NS-type LN were collected for retrospective analysis from January 1, 2009 to December 31, 2018. Results NS was found in 30 cases(28.0%)of 107 cases with LN. The ages of onset were 5-13 years, average(9.7±2.3)years. Among them, there were 6 males and 24 females with a male to female ratio of 1∶4. The most common extrarenal manifestation is anemia. Compared with non-NS-type LN patients, the proportion of acute kidney injury and hypertension was higher and the proportion of leukopenia was lower in NS-type LN patients(P<0.001;P<0.001; P=0.01). Renal biopsy showed the most common is class Ⅳ(54.5%), followed by class Ⅴ(22.7%), Ⅱ(13.6%), Ⅴ + Ⅱ(4.5%)and Ⅴ + Ⅳ(4.5%)in 22 cases. Thirty cases were given prednisone plus immunosuppressant, including intravenous methylprednisolone pulses(MMP)combined with cyclophosphamide(CTX)(63.3%), sequential usage of mycophenolate mofetil(MMF)after MMP(3.3%), only with CTX(10.0%), MMF combined with tacrolimus(6.7%), only with MMF(3.3%), and poor medication 山 东 大 学 学 报 (医 学 版)58卷2期 -阚娜娜,等.儿童肾病综合征型狼疮性肾炎30例临床、病理及近期疗效观察 \=-compliance(13.3%). After 6 months of treatment, 17 cases had complete remission, 8 cases had partial remission, 4 cases had no remission, and 1 case had died of severe pneumonia and severe sepsis. Conclusion The proportion of acute kidney injury and high blood pressure in NS-type LN patients is high than those in non-NS-type LN patients. In NS-type LN patients, the renal pathology is complex, and class Ⅳ type is the main pathological type. Among the patients with NS-type LN or pathological type of Ⅳ, MMP joint CTX is the main induction therapy, which can effectively induce remission.

Clinical application of digital implant guide in the absence of continuous multiple teeth in the mandibular posterior tooth area

HUANG Ping, SHANG Hongguo

Journal of Shandong University (Health Sciences). 2020, 58(2):  60-63.  doi:10.6040/j.issn.1671-7554.0.2019.1318

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Objective To explore the application value of digital implantation guide in continuous multiple tooth loss in the posterior mandibular region. Methods The clinical data of 60 patients with continuous multiple tooth loss were collected. According to their choice of treatment, the patients were divided into 2 groups. The research group(n=30)used digital implant guide to complete the implantation, the cone beam CT(CBCT)was photographed before operation to prepare the dentition model, and the implant guide was designed with a special implant software 3shape and printed with 3D printing. The control group(n=30)completed the implantation based on dentists experience. After operation, CBCT imaging was taken in both groups to evaluate the three-dimensional differences. The accuracy of implants was analyzed by measuring and comparing the three-dimensional positions designed before and after operation. Results The initial stability was good in both groups at the time of implantation, and there was no obvious swelling or pain, and patients were satisfied with the operation. There was no significant difference in the initial success rate of implantation 山 东 大 学 学 报 (医 学 版)58卷2期 -黄平,等.数字化种植导板在下颌后牙区连续多牙缺失下的临床应用 \=-between the 2 groups(P=0.379, P>0.05). The study group had smaller implants neck deviation value (t=10.567, P<0.001), apical deviation(t=10.784, P<0.001), angle deviation(t=8.245, w=529, P<0.001), and depth deviation(t=10.840, P<0.001). There was no significant difference in satisfaction between the 2 groups 3 months after surgery(P>0.05). Conclusion The digital implantation guide has high clinical application value in the repair of continuous multi-tooth loss, which makes the three-dimensional position of implants on the jawbone more accurate and rational, lays a good foundation for later crown restoration, and fully reflects the restoration-oriented planting concept.

Distribution and drug resistance change of clinical isolates in ICU of a new hospital

SUN Yanting, WU Dawei, WANG Xiaofei, XU Jian, WANG Rui

Journal of Shandong University (Health Sciences). 2020, 58(2):  64-71.  doi:10.6040/j.issn.1671-7554.0.2019.1088

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Objective To clarify the distribution and drug resistance change of clinical isolates in ICU of a new hospital, and to provide evidence for clinical infection prevention and management. Methods The distribution and drug sensitivity of positive strains were retrospectively analyzed from January 2014 to December 2018 in ICU. Bacteria identification was carried out by the full-automatic microbial identification instrument of French Merrier, and the relative numbers and chi-square test were mainly used for statistical analysis. Results 68.27% of 1784 strains were Gram-negative bacteria mainly from sputum(62.89%)and urine(11.49%), and most of them were Acinetobacter baumannii, Pseudomonas aeruginosa, Escherichia coli and Klebsiella pneumoniae. 21.13% of 1784 strains were Gram-positive bacteria mainly from blood(30.77%)and urine(23.08%), and most of them were Staphylococcus aureus and Enterococcus faecalis. Among the same species of bacteria, the detection rate of multidrug-resistant Acinetobacter baumannii(MDR-AB)was 93.75% in the second year. Extensively drug resistant Acinetobacter baumannii(XDR-AB)had been preva- 山 东 大 学 学 报 (医 学 版)58卷2期 -孙艳婷,等. 新建医院ICU临床分离菌的分布及耐药变迁 \=-lent in April 2015. The average detection rate of ESBLs-producing Escherichia coli(ESBLs-EC), carbapenem-resistant Pseudomonas aeruginosa(CR-PA), methicillin-resistant Staphylococcus aureus(MRSA)and methicillin-resistant Coagulase-negative staphylococcus(MRCNS)were 68.31%, 53.48%, 60.55% and 86.87%, respectively. One strain of vancomycin-resistant Enterococcus faecalis was detected in 2014. Conclusion The new ICU should strengthen prevention of Acinetobacter baumannii colonization and epidemics. The drug resistance of isolates, especially non-fermenting Gram-negative bacilli, staphylococcus and enterococci, is significant in ICU. It is necessary to monitor drug resistance of MDR-AB, CR-PA, MRSA, MRCNS and ESBLs-EC, prevent nosocomial infection, and select rational antibiotics according to the prevalence of drug resistance.

Detection of tumor cells, carbohydrate antigen 153, carbohydrate antigen 125 and carcinoembryonic antigen in peripheral blood circulation in 105 cases of ductal carcinoma in situ or with minimal invasive carcinoma

GUAN Yanfei, CHEN Zhiqiang, YUAN Chunlei, PENG Jianming, MI Xianjun, LIU Jun, CHEN Ang, YUAN Bin, LIU Zicheng

Journal of Shandong University (Health Sciences). 2020, 58(2):  72-78.  doi:10.6040/j.issn.1671-7554.0.2019.1154

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Objective To explore the diagnostic value of peripheral blood circulation tumor cell(CTC), carbohydrate antigen 153(CA153), carbohydrate antigen 125(CA125), carcinoembryonic antigen(CEA)on single or combined detection of ductal carcinoma in situ(DCIS)or with microinvasive carcinoma. Methods A total of 136 patients with benign breast disease(benign group), 105 patients with DCIS or with micro invasive cancer(malignant group)and 151 healthy people(control group)were selected as the study objects. The amount of CTC was measured by immunofluorescence in situ hybridization(IMFISH). The values of CA153, CA125 and CEA were measured by electrochemiluminescence. The value of single detection(CA153, CA125, CEA and CA153+CA125+CEA)and combined detection(CTC+CA153+CA125+CEA)in diagnosing DCIS or micro invasive cancer was analyzed. Results (1)For all the detection methods, the positive rate of malignant group was significantly higher than those in benign group and control group(P<0.01). (2)Compared with the single detection methods, the positive rate of combined detection method in malignant group was significantly higher(all P<0.001). (3) Compared with the control group and benign group, the detection values of CTC, CA153 and CA125 methods in malignant group were higher(P<0.001). (4) The sensitivity, specificity and coincidence rate were significantly different among the combined detection method and the single detection methods(P<0.001). (5) The areas under the curve of CTC, CA153, CA125, CEA,(CA153+CA125+CEA)and(CTC+CA153+CA125+CEA)detections were 0.873, 0.803, 0.775, 0.760, 0.900 and 0.959, respectively. Conclusion CTC+CA153+CA125+CEA detection method has a higher sensitivity and coincidence rate in the diagnosis of DCIS or with micro invasive cancer, larger diagnostic area of ROC curve and a better specificity.

Primary mediastinal seminoma: a case report and literature review

CHEN Rong, LI Haichao, ZHAO Jian

Journal of Shandong University (Health Sciences). 2020, 58(2):  79-84.  doi:10.6040/j.issn.1671-7554.0.2019.1070

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Objective To improve the recognition of primary mediastinal seminoma. Methods The clinical data of 1 patient with primary mediastinal seminoma were described, and the relevant references were reviewed. Results The patient was 29 years old, and diagnosed as Sertoli cell only syndrome(SCOS)before. Physical examination was negative in serological tests of AFP, β-HCG and etc. The patient was pathologically diagnosed as primary mediastinal seminoma after surgery. Conclusion Surgery and chemotherapy play important roles in the treatment of primary mediastinal seminoma, especially for the early tumors that are expected to be completely resected.

Correlation of vascular calcification indicators in 138 patients aged between 39 and 81 years

LI Na, ZHANG Zhimian

Journal of Shandong University (Health Sciences). 2020, 58(2):  85-89.  doi:10.6040/j.issn.1671-7554.0.2019.1321

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Objective To explore the relationship between bone mineral density(BMD), bonemetabolismrelated indicators and coronary artery calcification(CAC)in order to provide reference for the screening of high-risk CAC population. Methods This study involved 138 subjects(39-81 years)who underwent coronary artery CT angiography(CTA)during June 2018 and May 2019. According to the BMD results, the subjects were divided into osteoporosis group, osteopenia group and healthy group. The coronary artery calcium scoring(CACS)was calculated with Agatston score(AS), and the total CACS was obtained by summing up the scores of the branches. Based on the total CACS, the subjects were divided into CAC group(>10)and non-CAC group(≤10). The bone metabolism related indicators were recorded, including total Ⅰ type collagen amino peptide(tP1NP), extended β-Ⅰ type collagen peptide(β-CTx), fetal globulin A(Fetuin-A), parathyroid hormone(PTH), and other biochemical indicators. Results There were statistically significant differences in gender(P<0.001), age(P<0.001), pressure difference(P=0.01), fasting blood glucose(P<0.001), menopause(P=0.04), drinking history(P<0.001), smoking history(P<0.001), and lumbar spine density(P=0.01)between the CAC group and non-CAC group. There were no significant differences in tP1NP,β-CTx,PTH,Fetuin-A and ALP between the two groups(P>0.05). CACS was correlated with gender, age, differential pressure, 山 东 大 学 学 报 (医 学 版)58卷2期 -李娜,等.138例39~81岁体检人员血管钙化指标的关联分析 \=- fasting blood glucose, lumbar spinedensity, menopause, history of drinking and smoking. Age, fasting bloodglucose and lumbar spine density had a certain effect on CAC score. Conclusion In middle-aged and elderly people, lumbar spine densityis correlated with CAC and can be used as a predictor.

A study of unplanned readmission within 31 days during 2018 in a tertiary hospital in Jinan

ZHANG Yongyuan, WANG Qingliang, LI Xiangyi, LIU Yingjun, FEI Jianchun, YANG Jie

Journal of Shandong University (Health Sciences). 2020, 58(2):  90-95.  doi:10.6040/j.issn.1671-7554.0.2019.1457

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Objective To investigate the current status and influencing factors of unplanned readmission within 31 days after discharge in a tertiary hospital in Jinan. Methods A total of 2828 inpatients of unplanned readmission with 31 days during January 1st and December 31st, 2018 were enrolled. The descriptive analysis was employed, and Logistic regression was conducted to analyze the influencing factors. Results The unplanned readmission rate was 1.79%, and the mortality of unplanned readmission inpatients was 2.76%. The departments with high unplanned readmission rate focused on Department of Hepatology, Department of Rheumatology and Department of Geriatrics, and mainly due to chronic diseases and malignant tumors. The major influencing factors were inpatients age(OR=1.025,95%CI:1.023-1.028), previous length of stay in hospital(OR=1.021,95%CI:1.018-1.025), hospitalization times(OR=1.094,95%CI:1.087-1.101), district(OR=1.346, 95%CI: 1.244-1.455), marital status(unmarried: OR=3.280,95%CI:2.788-3.859; widowed: OR=1.954,95%CI:1.502-2.541), previous ways of discharge(discharge without doctors advice: OR=1.406,95%CI:1.173-1.685), previous operation(OR=0.628,95%CI:0.577-0.684)and medical insurance status(OR=0.594,95%CI:0.537-0.657). Conclusion The hospital should improve the supervision of unplanned readmission, standardize the diagnosis and treatment process, avoid decomposition of hospitalization, promote the hierarchical medical system, correctly guide the needs of patients, reduce the unplanned readmission rate and lighten the burden of patients.

Relationship between work-family balance and boundary flexibility of married nurses

LI Yanyan, YANG Bei, WANG Juan, LI Jiahuan, WANG Ying, CAO Fenglin

Journal of Shandong University (Health Sciences). 2020, 58(2):  96-102.  doi:10.6040/j.issn.1671-7554.0.2019.1227

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Objective To investigate factors influencing the work-family balance of married nurses in third-class hospitals, and to explore the relationship between different levels of boundary flexibility of nurses and work-family balance. Methods A total of 1 023 nurses were selected from 4 third-class hospitals in Shandong Province and surveyed with boundary flexibility questionnaire and work-family balance questionnaire. All dimensions of boundary flexibility, namely work flexibility ability, work flexibility willingness, family flexibility ability and family flexibility willingness, were divided into high score group and low score group according to the mean value. The flexibility ability and willingness in work fields were matched, and the family fields were also matched in pairs to understand the work-family balance of different matching groups. Results There were statistical differences in work-family balance, including work-family conflict, work-family enhancement, family-work conflict and family-work enhancement, in terms of presence or absence of underage children, working years and weekly working hours. The differences in work-family conflict(F=5.90, P<0.01)and work-family enhancement(F=3.22, P<0.05)among different groups were statistically significant. The differences in family-work conflict(F=28.41, P<0.01)and family-work enhancement(F=12.08, P<0.01)were statistically significant. Conclusion The age of married nurses, presence or absence of underage children, working years and weekly working hours can affect the work-family balance, and nurses with different types of boundary flexibility 山 东 大 学 学 报 (医 学 版)58卷2期 -李艳艳,等.已婚护士工作家庭平衡与边界弹性的关系 \=-willingness have different experiences of work-family balance.

Chain mediating effects of mindfulness and rumination on the relationship between job stress and sleep quality among nurses

LI Jiahuan, WANG Juan, CHEN Qingyi, LI Yanyan, ZHAO Jing, CAO Fenglin

Journal of Shandong University (Health Sciences). 2020, 58(2):  103-108.  doi:10.6040/j.issn.1671-7554.0.2019.992

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Objective To explore the mediating role of mindfulness and rumination on the relationship between job stress and sleep quality in nurses. Methods A total of 712 nurses were surveyed with questionnaires of Nurse Job Stressors Inventory(NJSS), Pittsburgh Sleep Quality Index(PSQI), Short Inventory of Mindfulness Capability(SIM-C)and Ruminative Responses Scale(RRS). A chain mediation model was built using Amos21.0. Results The acting with awareness score was negatively correlated with scores of NJSS, RRS and PSQI(r=-0.26, r=-0.47, r=-0.22, all P<0.001). RRS score was positively correlated with scores of NJSS and PSQI(r=0.36, r=0.36, both P<0.001). The structural equation model showed that acting with awareness and rumination had chain mediating effects between job stress and sleep quality(χ2/df=2.28, GFI=0.963, AGFI=0.947, NFI=0.948, IFI=0.970, CFI=0.970, TLI=0.962, PNFI=0.743, PGFI=0.666, RMSEA=0.042). Bootstrap test showed that 95%CI of the chain mediating effects of acting with awareness and RRS were 0.12 and 0.21. Conclusion Job stress affects sleep quality through both mindfulness and rumination.

Relevant research on macrosomia from 1999 to 2018

LIN Mengmeng, LIU Yang, GAO Rong, YU Zhixia, GAO Lijie, WANG Zhiping

Journal of Shandong University (Health Sciences). 2020, 58(2):  109-117.  doi:10.6040/j.issn.1671-7554.0.2019.1055

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Objective To analyze the status quo and hotspot of researches on macrosomia and to predict future research trends in this field. Methods Papers included in the SCI-E database from 1999 to 2018 were adopted as research objects, and were analyzed by bibliometric and VOS viewer data visualization software. Results A total of 1952 papers were enrolled. The results showed that: (1) The number of related papers was generally increased every year. The United States and the United Kingdom were the main contributors to the literatures in this field. The funding agencies and funded articles were the most in the United States. Caughey AB, coming from the United States, had rather a large influence. (2) The annual publication volume in China surpassed the United States and became the No.1 in 2018, and 67.6% of these articles were funded. (3) There appeared different research angles and directions after 2009, but the main direction had not changed. The total citation frequency of papers were declined since 2014. Conclusion The research of macrosomia is a hotspot always, but the research level in China needs to be further improved, and the biological pathogenesis of macrosomia remains to be further explored.